Do You Have to Worry About Monkeypox? 6 Questions and Answers

The last thing anyone wants to hear is news of another unfamiliar virus spreading throughout the world. So it’s understandable that people are concerned about the monkeypox virus, which causes lesions on the skin and fever but is rarely deadly.

About 120 cases of monkeypox have been confirmed or suspected recently outside of west and central Africa, where the virus is found, according to the World Health Organization. These places include the U.S., Canada, Australia and several countries in Europe.

The reassuring news: UNC Health infectious diseases specialist David Wohl, MD, says the risk of a widespread outbreak of monkeypox is highly unlikely, echoing similar assurances from the Centers for Disease Control and Prevention and the North Carolina Department of Health and Human Services.

Despite the name, monkeypox is not spread by monkeys; rather, it was named after an outbreak of the virus in laboratory monkeys. Rodents in Africa carry the virus, which is in the same family as smallpox. Fortunately, it is much milder than smallpox, which killed more than 300 million people in the 20th century and was eradicated worldwide in 1980.

Also reassuring: Monkeypox is much harder to spread than COVID-19, Dr. Wohl says.

“Monkeypox is not nearly as infectious as COVID-19 or influenza,” he says. “Unlike those infections, this is not spread by aerosols. It takes closer, more direct contact. Certainly, it takes much more intimate contact than you would get with someone on a subway or a plane.”

For more answers to questions you might have about monkeypox, read on.

1. What is monkeypox?

Monkeypox is a rare virus that causes lesions on the skin. It was identified in 1958 when it broke out among research monkeys. The first case in humans was seen in 1970. The vast majority of cases have been reported in central and western African countries. Most cases in other parts of the world have been linked to African travel or to animals imported from Africa.

The only significant outbreak in the U.S. occurred in 2003, when 47 cases were identified in six Midwestern states. All 47 reported that they had contact with pet prairie dogs. The prairie dogs had been infected after being kept near small rodents imported from West Africa. So far this year, there is one confirmed case and a handful of suspected cases in the U.S.

2. How contagious is monkeypox?

The monkeypox virus is much harder to spread than the viruses that cause COVID-19 or the flu. On average, people who have COVID-19 spread the virus to between four and eight other people, Dr. Wohl says. The average transmission rate for people with monkeypox is less than one other person.

“It doesn’t transmit easily,” Dr. Wohl says, “so I expect we will see this (outbreak) die out pretty quickly.”

The CDC says people can contract the virus through contact with an infected animal (a bite or scratch), an infected human (via body fluids or lesions) or contaminated materials, including bedding and clothes. Respiratory droplets containing the monkeypox virus can travel only a few feet, so prolonged face-to-face contact is required for airborne infection.

3. What are the symptoms of monkeypox?

Monkeypox symptoms are similar to but milder than the symptoms of smallpox. People with monkeypox may first experience a fever, headache, muscle aches, fatigue and swollen lymph nodes. Within a few days of the fever’s onset, the person will experience bumps on the skin that typically start on the face and can then pop up on other parts of the body.

Monkeypox is sometimes confused with chickenpox and shingles, Dr. Wohl says.

“Most adults who’ve had chickenpox don’t get it again,” he says. “They can get shingles, but that’s typically in a patch of skin on one side of the body. Monkeypox lesions can be seen anywhere on the body, including the palms or soles.”

The important thing, he says, is to see a doctor if you notice a strange new skin bump that looks to be fluid-filled, especially if you also feel sick. People can have only one or a handful of these bumps.

“Not every bump that a person notices should lead to a call to the doctor. Monkeypox do not look like your average pimple. If you see something on your skin that looks unusual and you have fevers or swollen glands, then you should seek care,” he says.

Dr. Wohl notes that in some of the recent cases, the monkeypox sores were on the genitals and initially mistaken for a sexually transmitted infection, such as syphilis. A new genital sore should always be checked out at a clinic.

4. What is the treatment for monkeypox?

Currently, there is no proven, safe treatment for monkeypox, according to the CDC.

The smallpox vaccine protects against monkeypox, Dr. Wohl says, and if necessary, it could be given to healthcare providers caring for infected patients or others who have been exposed to someone with monkeypox. However, he doesn’t expect a need for mass vaccinations for monkeypox. Right now, smallpox vaccines are not available to the public.

5. How long does monkeypox last?

The illness typically lasts for two to four weeks. The incubation period, from infection to symptoms, is typically one to two weeks.

Most people with monkeypox recover fully without any treatment, but about 1 percent of those infected can die from the disease, Dr. Wohl says.

6. How do you prevent monkeypox?

Unlike COVID-19, people don’t seem to be able to spread monkeypox for very long before they show symptoms, so it’s easier to avoid exposing others unknowingly.

“We will not see large numbers getting infected with monkeypox,” Dr. Wohl says.

Washing your hands thoroughly and frequently is an effective way to prevent many infectious diseases, monkeypox included. Avoid contact with lesions or sores on other people. Don’t spend prolonged time face-to-face with someone who has any symptoms of monkeypox, such as a fever or rash.

If you are concerned about symptoms you are experiencing, see your doctor or find one near you.